The intraoperative portable CT scanner-based spinal navigation: a viable option for instrumentation in the region of cervico-thoracic junction
Language English Country Germany Media print-electronic
Document type Journal Article
PubMed
26983423
DOI
10.1007/s00586-016-4476-6
PII: 10.1007/s00586-016-4476-6
Knihovny.cz E-resources
- Keywords
- Cervical and thoracic vertebrae, Computer tomography, Intraoperative imaging, Pedicle screw, Spinal instrumentation,
- MeSH
- Surgery, Computer-Assisted methods MeSH
- Thoracic Vertebrae * diagnostic imaging surgery MeSH
- Cervical Vertebrae * diagnostic imaging surgery MeSH
- Humans MeSH
- Orthopedic Procedures instrumentation methods MeSH
- Pedicle Screws * MeSH
- Tomography, X-Ray Computed methods MeSH
- Prospective Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
PURPOSE: Innovative intraoperative imaging modalities open new horizons to more precise image acquisition and possibly to better results of spinal navigation. Planning of screw entry points and trajectories in this prospective study had been based on intraoperative imaging obtained by a portable 32-slice CT scanner. The authors evaluated accuracy and safety of this novel approach in the initial series of 18 instrumented surgeries in anatomically complex segment of cervico-thoracic junction. METHODS: We report on the single-institution results of assessment of anatomical accuracy of C5-T3 pedicle screw insertion as well as its clinical safety. The evaluation of total radiation dose and of time demands was secondary endpoint of the study. RESULTS: Out of 129 pedicle screws inserted in the segment of C5-T3, only 5 screws (3.9 %) did not meet the criteria for correct implant positioning. These screw misplacements had not been complicated by neural, vascular or visceral injury and surgeon was not forced to change the position intraoperatively or during the postoperative period. Quality of intraoperative CT imaging sufficient for navigation was obtained at all spinal segments regardless of patient´s habitus, positioning or comorbidity. A higher radiation exposition of the patient and 27 min longer operative time are consequences of this technique. CONCLUSIONS: The intraoperative portable CT scanner-based spinal navigation is a reliable and safe method of pedicle screw insertion in cervico-thoracic junction.
See more in PubMed
J Neurosurg Spine. 2012 Mar;16(3):238-47 PubMed
J Spinal Disord Tech. 2007 Feb;20(1):25-32 PubMed
J Bone Joint Surg Am. 1995 Aug;77(8):1200-6 PubMed
Spine J. 2009 Oct;9(10):817-21 PubMed
Acta Med Okayama. 2010 Jun;64(3):209-12 PubMed
J Bone Joint Surg Am. 1995 Aug;77(8):1193-9 PubMed
J Spinal Disord. 2001 Feb;14(1):39-45 PubMed
Spine (Phila Pa 1976). 2013 Oct 15;38(22):1953-8 PubMed
Eur Spine J. 2008 Apr;17(4):564-75 PubMed
Eur Spine J. 2016 Mar;25(3):716-23 PubMed
Eur Spine J. 1997;6(1):19-24 PubMed
Spine (Phila Pa 1976). 2000 Mar 1;25(5):615-21 PubMed
J Neurosurg Spine. 2006 Dec;5(6):520-6 PubMed
Orthop Surg. 2010 Feb;2(1):27-31 PubMed
Spine (Phila Pa 1976). 2004 Feb 1;29(3):333-42; discussion 342 PubMed
Eur Spine J. 2013 Jan;22(1):148-55 PubMed
Spine (Phila Pa 1976). 2004 Apr 1;29(7):767-73 PubMed
